PROGRAM OPERATIONS MANUAL SYSTEMPart HI – Health InsuranceChapter 010 – Premium CollectionsSubchapter 15 – Trust Fund AccountingTransmittal No. 2, 02/04/2021
This is a Quick Action Transmittal and no change to policy and procedure.
Summary of Changes
HI 01015.010 Description of Accounts and Trust Funds
Updated POMS section with correct extension numbers.
A trust fund is the primary receptacle for money which has been collected or deducted and is used to pay the various types of benefits. An account is merely a sub-division or breakdown of a trust fund. For example, the Federal Supplementary Medical Insurance Trust Fund is divided into collection accounts for the aged and the disabled. The following is a list and description of accounts and trust funds that will be encountered in the processing of retirement, disability, hospital, and medical insurance benefit payments and premium collections.
This account is the receipt account for collections and deductions of SMI premiums from those age 64 years and 11 months old and over. In the case of collections, all health insurance premiums collected, including HI premium collections and SMI premium collections from the disabled are deposited in this account. They are subsequently redistributed by the Separate Operation for Billing, Entitlement, and Remittances (SOBER) program as the system applies them to the proper account.
This account is the receipt account for collections and deductions of SMI premiums from those who are age 64 years 10 months or under. All deductions made by the program service center from persons in the age group will be credited to this account (regardless of which trust fund the money comes from). All receipts from this age group will be credited to 20 × 8004.5 and redistributed to this account by the SOBER program as noted above.
This account is the receipt account for collections of HI premiums from those required to pay for this coverage. Actually, all receipts are deposited to 20 ×8004.5 and redistributed to this account by the SOBER program as the receipts are applied to the account.
NOTE: In the above three situations, where SOBER makes the distribution, distribution totals will be outputted in Central Office where the Financial Management Branch of the Office of Administration will take the necessary transfer action. No program service center action will be necessary to effectuate this transfer.
All retirement and survivors insurance (RSI) benefits are certified from this fund. In addition, all recovery receipts in the RSI offices (except premium receipts and those which cannot be identified) are deposited to this fund.
All disability benefits are certified from this fund. In addition, all recovery receipts in the Office of Disability Operations (except premium receipts and those which cannot be identified) are deposited to this fund.
This is the fund from which medical insurance benefits are paid. The program service center is not authorized to make payments from this fund. The only occasion when the program service center will make entries to this account will be when the program service center effectuates the recovery of a
of SMI through a deduction from benefits. Such instances are rare and will only be accomplished as directed.
This is the fund from which hospital insurance payments are made. This fund is used by the program service center only to handle
of HI under the conditions stated above for SMI.
This account is used to hold receipts which appear to belong to the Social Security Administration but for which the program service center cannot identify the account to which they apply. From time to time the Treasury Department may notify the program service center that they have made an entry to this account. Benefit Authorizers and Health Insurance and Inquiries Examiners usually will not use this account.
All supplemental security income (SSI) payments are certified from this account. Normally, funds will only be deposited to this account and not charged from it as the program service centers are not authorized to make payments from this account (e.g., it may be necessary to deposit SSI money erroneously deposited into the FOASI trust fund into the SSI Appropriation Account).
Railroad Retirement Board (RRB) annuity payments are certified from this account. Any money transferred from SSA to RRB is placed in this account and the transfer will be accomplished only by the Fiscal Control and Audit Branch in Central Office. Therefore, this block should not be completed by program service center personnel.
This box has not been designated for any use at this time and should not be completed.